As ações em saúde mental nos Núcleos de Apoio à Saúde da Família - NASF

The National Police for Basic Care (PNAB), regulated by ordinance nº2488 from October 2011, restates the Family Health Strategy (ESF) as a priority to the expansion, consolidation and qualification of basic attention to health matters in Brazil. In order to bring it about, city counsellors along with other federal entities ought to ordinate their work process deepening principals, directions and fundaments of Basic Care (AB). Besides ESF, the new PNAB expatiates on the Family Health Support Centres (NASF), reaffirming their role on broadening the scope of basic care actions and their improvements, ratifying their ability to share knowledge and support Basic Care professionals. All this considered, the purpose of this work is to investigate how NASF is currently structured in João Pessoa and what has been achieved by it on what concerns to mental health. Its main objectives are to analyse the practices of mental health professionals that are part of NASF teams and if they differ from what has been developed by the other members of the teams; to discuss the articulation of NASF in managing mental health measures on what concerns to internal organisatio n and to the city health network; to identify strategies used to organise such measures on mental health in Basic Care. To reach such goals, individual interviews have taken place two city health managers and four of NASF professionals that participated on the Mental Health Office as representatives of their sanitary districts. Also a focal group formed by various supporters of NASF was created, contemplating the diversity of professional categories involved with the teams and sanitary districts. It was possible to identify in NASF, in João Pessoa, an organisation based by the matrix support in which both management and basic care demands reflect a series of actions developed alongside with ESF. Amongst such actions, matrixing, home visits and the Singular Therapeutic Project (PTS) stand out. These activities have been discussed on the focal group and integrate the daily work of all NASF supporters despite their professional categories. NASF presents itself as a powerful strategy to SUS proper qualification and support to strengthen Basic Care and broaden family health teams‟actions.

A produção do cuidado no período gravídico-puerperal: experiência de mulheres usuárias de serviços públicos de saúde

Despite numerous government projects aimed at reorganizing and qualifying obstetric and neonatal care in Brazil, it remains problematic, with repercussions for maternal and newborn mortality and humanized care of both the mother and child. The objective of this study was to analyze the care provided to women during the pregnancy-puerperium cycle, based on reports of public health service users regarding their pregnancy and delivery experiences, using comprehensiveness and humanization as reference. The study applied a qualitative approach and the methodological strategy consisted of listening to the women, in order to identify, based on the meanings of their discourse concerning their experiences with health services, continuities and discontinuities of care during the pregnancy-puerperium cycle. Study participants were women who gave birth at a municipal public maternity, residents of Natal, Brazil, who at the time of the interviews, were between 10 and 42 days postpartum. Seven women reported their pregnancy and delivery experiences at public services. As interviews and observation took place, the material produced was also analyzed, in order to achieve simultaneous production and data analysis. Using systematization, a dialogue was established between the women’s discourses and production in the field of Collective Health, with respect to concepts and discussion about obstetric and neonatal care as well as the Comprehensiveness and Humanization of such care. Participant discourses underscored aspects related to prenatal care starting at pregnancy and its repercussions as well as prenatal monitoring by health services; aspects associated with care during labor and delivery, as well as those involved in postpartum in the maternity, both with respect to newborn and maternal careç and lastly, puerperium care after discharge from the maternity. Analysis of results sought to identify lines of continuity and discontinuity in the comprehensiveness and humanization of care. Based on these lines and as final contributions of the study, the following paths were proposed to achieve comprehensive and humanized production of health care for women during the pregnancy-puerperium cycle: Path 1- Reassess care in the maternal and newborn health network, aimed at comprehensiveness in terms of guaranteeing access to the various services and technological resources available to enhance health and life. Path 2- Reorganize work processes in order to attain comprehensive and humanized care for women in the pregnancy-puerperium cycle. Path 3 – Qualify the professional-user relationship in care management during the pregnancy-puerperium cycle. Path 4 – Invest in the qualification of communication processes in the different dimensions of care during the pregnancy-puerperium cycle.

A produção do cuidado no período gravídico-puerperal: experiência de mulheres usuárias de serviços públicos de saúde

Despite numerous government projects aimed at reorganizing and qualifying obstetric and neonatal care in Brazil, it remains problematic, with repercussions for maternal and newborn mortality and humanized care of both the mother and child. The objective of this study was to analyze the care provided to women during the pregnancy-puerperium cycle, based on reports of public health service users regarding their pregnancy and delivery experiences, using comprehensiveness and humanization as reference. The study applied a qualitative approach and the methodological strategy consisted of listening to the women, in order to identify, based on the meanings of their discourse concerning their experiences with health services, continuities and discontinuities of care during the pregnancy-puerperium cycle. Study participants were women who gave birth at a municipal public maternity, residents of Natal, Brazil, who at the time of the interviews, were between 10 and 42 days postpartum. Seven women reported their pregnancy and delivery experiences at public services. As interviews and observation took place, the material produced was also analyzed, in order to achieve simultaneous production and data analysis. Using systematization, a dialogue was established between the women’s discourses and production in the field of Collective Health, with respect to concepts and discussion about obstetric and neonatal care as well as the Comprehensiveness and Humanization of such care. Participant discourses underscored aspects related to prenatal care starting at pregnancy and its repercussions as well as prenatal monitoring by health services; aspects associated with care during labor and delivery, as well as those involved in postpartum in the maternity, both with respect to newborn and maternal careç and lastly, puerperium care after discharge from the maternity. Analysis of results sought to identify lines of continuity and discontinuity in the comprehensiveness and humanization of care. Based on these lines and as final contributions of the study, the following paths were proposed to achieve comprehensive and humanized production of health care for women during the pregnancy-puerperium cycle: Path 1- Reassess care in the maternal and newborn health network, aimed at comprehensiveness in terms of guaranteeing access to the various services and technological resources available to enhance health and life. Path 2- Reorganize work processes in order to attain comprehensive and humanized care for women in the pregnancy-puerperium cycle. Path 3 – Qualify the professional-user relationship in care management during the pregnancy-puerperium cycle. Path 4 – Invest in the qualification of communication processes in the different dimensions of care during the pregnancy-puerperium cycle.

Articulação terriotiral e sustentabilidade: estudo sobre o gerenciamento de resíduos de serviços de saúde no ABC Paulista

Tese apresentada ao Programa de Pós-Graduação em Administração da Universidade Municipal de São Caetano do Sul para a obtenção do título de Doutor em Administração

Comunicação pública e marketing político na gestão pública municipal

Based on the definitions of Public Communication, Political Marketing, Public Interest Information and Communication as a Tool of Governance, the study notes the use of the news section of the websites of the City Christmas and Mossoro, Rio Grande do Norte, in regard to strengthening citizenship and encouraging participatory management, from the characterization of materials like pieces of Political Marketing and Public Communication. Data collection in qualitative research was conducted from August to September 2011 and content analysis showed that the appropriation of public property for personal use is a reality, despite legal requirements to the detriment of strategic communication and governance for results from the dissemination of information of public interest and the establishment of a communication channel between State Government and Society. Elements of this study suggest the need for further research to deepen the discussion

Gestão democrática nas escolas: a atuação dos diretores escolares e os desafios para sua consolidação na rede municipal de Natal/RN

The democratic management is a challenge for education, on the one hand for its actualization needs a link between the government and the educational institution. From that, research aims to understand the main challenges faced by the school administration to consolidate the management of public schools in Natal/RN. Against this context the methodology used was multiple cases, qualitative approach in which respondent were manager (director, deputy director and coordinator) of the four municipal schools and two representatives of the Democratic Management Commission of a Government departament of Education, Natal/RN. The analysis was made by peers, between schools that had grade superior IDEB that average stipulated by the federal government and two that had grade lower and between managers and representatives of the Secretary. Were used techniques of categorization and content analysis of the speeches of respondents. Was note that managers understand the importance of the participation about whole community in the democratic management, however only one school highlighted means of attracting the parents against to the difficulty of representing these. The lack of knowledge about the democratic management is evident mainly in the pair of schools with lower IDEB. That schools with a lower IDEB adhere to this management as a way to meet rules. So unanimous, the broad role of director hampers knowledge about the legislation. About relationship of the Government department with managers, there are some contradictions between the understanding of the role of the coordinator by managers and representatives of the Government department. It was perceptible the no uniformity about a good relationship between managers and Government department. It was notable features of democratic management in all school units, well as the efforts of the Government department in this scope. However there are also undemocratic features that deserve further study

Percepção dos profissionais de saúde do Hospital Municipal do Huambo-Angola sobre a fisioterapia: projecto de implementação de um serviço de fisioterapia

Mestrado em Fisioterapia.

Implementação de um Sistema de Gestão Integrado da Qualidade e da Segurança e Saúde do Trabalho na empresa máximo internacional Imp. Exp. S.A.

Dissertação de Mestrado em Gestão Integrada da Qualidade, Ambiente e Segurança

Modelo de gestão do conhecimento para a unidade organizacional de saúde

Nos últimos anos têm surgido vários debates e estudos sobre a importância do conhecimento. As organizações consideram a Gestão do Conhecimento (GC) uma vantagem competitiva, capaz de gerar riqueza e poder. Para tal necessitam de desenvolver mecanismos e de ter pessoas com capacidade de criar, compartilhar e disseminar conhecimentos na organização. As Tecnologias de Informação e os Sistemas de Informação são uma ferramenta de grande impacto na GC, pois assumem um papel importante no sucesso e na renovação dos conhecimentos. A partir do Modelo de GC desenvolvido por Nonaka e Takeuchi, o Modelo Metavisão, e as técnicas de Business lntelligence, elaborou-se um Modelo de Gestão do conhecimento para a Unidade de Saúde. Com este modelo pretende-se obter beneficies, que passam pelo desenvolvimento de mecanismos de comunicação interna, formação e melhorias no processo de tomada de decisão. ABSTRACT; During the last years, debates and studies have arisen in relation to the importance of knowledge. The organizations consider Knowledge Management a competitive advantage, capable of generating wealth and power. Therefore, new mechanisms have to be developed in the organizations and employ people with capacity to create, share and disseminate knowledge. The information and Communication Technology is an important tool and has a great impact on Knowledge Management because it assumes an important role in the success and the renovation of knowledge. The Model of Knowledge Management developed by Nonaka and Takeuchi, the "Metavision" Model and the techniques of Business intelligence were the starting point to elaborate a Model of Knowledge Management for a Health Unit. With this model we aim to obtain benefits, such as development of mechanisms of internal communication, training plans and improvement during the process of decision making.

A gestão da pessoa com hipertensão arterial na unidade móvel de saúde

Enquadramento: A gestão da doença, designadamente da hipertensão arterial (HTA) através do apoio à auto-gestão, aconselhamento motivacional, acesso à informação resultam em maior adesão terapêutica. Objetivos: Identificar os fatores que determinam a adesão ao tratamento na pessoa com HTA numa amostra comunitária. Metodologia: Estudo transversal, descritivo-correlacional, com amostra de 235 hipertensos (63,8% do género feminino), idade média 75 ± 8,14 anos, 62,6% casados e a maioria com o 1.º ciclo de escolaridade. Recorremos ao questionário com variáveis sociodemográficas, dietéticas, clínicas, motivacionais, relacionadas com os profissionais e serviços de saúde, Escala de Apgar Familiar, Questionário de Dependência Alcoólica, Questionário Internacional de Atividade Física, Questionário de Determinação da Saúde Nutricional, Escala de Autocuidado com a Hipertensão, Questionário de Crenças Sobre a Doença, Escala de Crenças Acerca dos Medicamentos, Escala de Satisfação dos Utentes com os Cuidados de Enfermagem na Unidade Móvel de Saúde, Questionário abreviado da Perceção do Cliente sobre o Ambiente Terapêutico, Questionário de Autorregulação, Escala de Competência Percebida e Escala de Medida de Adesão aos Tratamentos para colheita de dados. Resultados: A pressão arterial estava controlada em 34,5% da amostra, 28,2% homens e 38% mulheres. A MAT revelou um mínimo de 3,86 e um máximo de 6 com uma média de 5,66±0,49. As variáveis preditoras da adesão foram: controlo pessoal (p=0,005), identidade (p=0,000), ambiente terapêutico (p=0,001), alimentação geral (p=0,041), atividade física (p=0,007) e toma de medicamentos (p=0,000). Conclusões: Compreender os fatores envolvidos na gestão do tratamento permite perceber como podem os enfermeiros contribuir para melhorar a adesão ao regime terapêutico. Palavras-chave: Hipertensão arterial, gestão da doença crónica, adesão ao tratamento e adultos.

Implementação da norma NP 4397:2008 - sistemas de gestão da segurança e saúde do trabalho

Dissertação de Mestrado em Gestão Integrada da Qualidade, Ambiente e Segurança

Sistema de gestão em segurança e saúde do trabalho (SGSST) integrando a norma OHSAS 18001 e NR-18: proposta para o setor da construção civil

The job security issue is crucial for the development of construction due to the need to ensure the health of workers, which is done by means of laws and production management. Thus, among various other laws, was enacted NR-18, in order to ensure the worker's minimum conditions for the development work. Despite legislative developments on the subject, they have become ineffective against the excessive number of accidents in the construction industry, bringing the company to greater in ensuring the health and safety of its workers. In view of this need for improvement of working environment in a general appearance, both for purposes of ensuring the law obedience as comfort for workers and quality of the organization, the System Health Management and Safety (OHSMS) is a valid tool demonstrates the evolution of business management, as well as OHSAS 18001 which proposes to ensure the efficiency and integration of a system geared to safety and health at work by means of implements and adaptations of it, in order to bring significant improvements to conditions of work, especially in the form of a new culture to be adopted by the company. Addressing the problem, this paper aims to develop a management system by OHSAS 18001 which is consistent with the terms of NR-18 as it is this integration of OHSMS Management System of the company as a usual practice of that aims at an improvement of work safety in the business of Buildings.

Programa pró-equidade de gênero e raça da Prefeitura Municipal de Curitiba: estratégia para superar a divisão sexual de trabalho em uma instituição pública?

The objective of this study was to analyze if the pro equity program of gender and race in the PMC, changed the perception of the servants on the conception of sexual division of labor. The sexual division of labor is the concept that allows identifying and understanding the hierarchical relations (principal of hierarchization) based on the attribution of social and economic value most male occupations in relation female, besides that, considerers the female work‟s secondary and her salary supplement to the family income. And the principle of separation identifying the places occupies by man and woman in the institution (productive, reproductive, and domestic work) agreeing with the historical and social construction that associates woman to occupational sectors like “mastertship”, nursering and social assistance, considered an extension of the family functions like taking care and family affections. And the man is associate to engineer, technology information and occupations related to exact science all professions associate to reason, creating a bias of gender in labor relations. To identify possible inequalities of gender in the work ambiance, I have compared the initial basic duration of some careers, the ascension process to higher positions and the salary that both servants and servers in the PMC. Was also investigated the perception of implements and beneficiaries of the program, over the sexual labor division. The methodology used for conduct the investigation was the qualitative research interpretive character using the structured and semi structured interviewed as instruments of data collect. The interview was divided in two groups, to follow: a) implements of pro-equity program of gender and race and b) professors and engineers beneficiaries. The analyzes of documents provided by the Secretaria de Politícas para as Mulheres da Presidência da República and by the PMC complemented the investigative path of this research. Bring as result a perception of beneficiaries servants and implementing on a policy which provides for cultural changes in the institution and in the management of people. It should be noted that the program foresees that in its objectives identify the discriminatory relations of race, sexual orientation, generation and disable person who were not examined in this study. Factor that enables the continuation of the investigation process and is a suggestion for a future research.

Caracterização geoquímica dos ecossistemas na zona de protecção às Fontes das Cinco Bicas e da Saúde

O concelho de Pombal possui uma elevada riqueza em Recursos Naturais, nomeadamente em Recursos Minerais e Nascentes Naturais. De entre as Nascentes Naturais existentes neste concelho, as Fontes das Cinco Bicas e da Saúde, têm sido privilegiadas, devido à qualidade bacteriológica e química das suas águas e à sua localização geográfica (zona ainda não abastecida com água da rede pública), sendo alvo de estudos e de um vasto trabalho, por parte do Município, de onde surgiu a delimitação de uma Zona de Protecção, de importância relevante para a população concelhia. A Zona de Protecção às Fontes das Cinco Bicas e da Saúde, abrange três zonas, sendo elas designadas por próxima, intermédia e alargada. Este estudo, tem como objectivo fundamental, a caracterização geoquímica e ambiental, de uma área de 8 Km2, envolvendo a zona delimitada como “Zona de Protecção às Fontes das Cinco Bicas e da Saúde”, utilizando os solos e a água como meios amostrais. A área de trabalho abrange também parte da Área declarada de Reserva (Área de Reserva – A), para efeitos de aproveitamento de Argilas Especiais (Decreto – Regulamentar n.º 35/95, de 22 de Novembro), e toda ela está inserida na área declarada Cativa, para efeitos de exploração de Argilas (Portaria n.º 448/90 de 16 de Junho), pelo que existem vários núcleos de actividade extractiva em laboração. Este trabalho vai permitir caracterizar ambientalmente a área de estudo, a água das nascentes em causa, bem como analisar a possível interferência das unidades industriais e agrícolas nas Fontes das Cinco Bicas e da Saúde.

A perspectiva dos profissionais de saúde nas inovações de gestão: Estudo de caso numa unidade de saúde

A necessidade de conciliar uma procura cada vez maior com as restrições de recursos humanos e financeiros levou a que se implementasse um conjunto de inovações que permitisse alcançar maior eficiência. No presente estudo aborda-se uma dessas iniciativas: os Hospitais SA. As implicações originadas por esta medida, ocorreram em termos de alterações de gestão e adopção de novos conceitos. Estas são algumas das dimensões estudadas. Em termos metodológicos pretende-se perceber como é que alguns dos profissionais de Saúde avaliam as modificações que ocorreram. Para tal, optou-se por levar a cabo um estudo de caso de um Hospital SA da região de Lisboa e Vale do Tejo, numa abordagem qualitativa, visando identificar a perspectiva dos profissionais de saúde nas inovações de gestão, relacionadas com as novas tecnologias, das quais se destacam: • Utilização da Internet; • Implementação e utilização da Intranet; • Desenvolvimento de Arquivos Digitais relativos a processos médicos; • Cartão Vital; • Aplicação Medivital. Para a recolha de dados será utilizada uma entrevista sarni-estruturada “que atribui maior liberdade ao investigador para conduzir a entrevista como achar ser mais conveniente, para a obtenção de dados que se revelem pertinentes" (Patton, 1990). Abstract; The need to conciliate the increasing search for healthcare over time with the restrictions of human and financial resources conducted to the implementation of a set of innovations that allowed a greater efficiency. ln the present study, one of those initiatives is presented: in the Hospitais SA. The implications of this measure occurred in terms of management modifications and in the adoption of new concepts. These are some of the studied dimensions. ln methodological terms, it’s intended to perceive how health professionals evaluate the modifications that occurred. For such, it was opted to present a case study of a Hospital SA from Lisboa e Vale do Tejo region, in a qualitative approach, aiming to identify the health professionals perspective of the management innovations related to the new technologies, from which the following, stand out: • Internet usage; • Implementation and use of Internet; • Development of Digital Archives related to medical processes; • Vital Card; • Medivital application. For data gathering a half-structuralized interview will be used "which gives greater freedom to the researcher to conduct the interview as he finds most convenient, in order to obtain relevant data" (Patton, 1990).